NHS Dentistry

NHS Dentistry

Tim Yeo: Is it Government policy to close community hospitals and force patients to travel 40 miles to overstretched general hospitals? Is it Government policy for primary care trusts to issue grossly misleading consultation papers, which omit costings of replacement services, and to withdraw existing hospital-based services before even the most rudimentary community alternatives are in place? If none of those are Government policy, why is the Secretary of State allowing the West Suffolk primary care trust to do all three in my constituency now?

Brian Jenkins: Will my right hon. Friend issue instructions to the external panel on this issue? Many of us support having a review to save management and associated costs, so that the money can be passed to the front line. But given that the average number of patients in a west midlands PCT is 230,000, we regard with great difficultly the proposed figure of 730,000 patients for a shire county area. Such a PCT will not be local, and because we will need area managers, the funding savings that we are looking for will not be made.

Dennis Skinner: Is the Secretary of State aware that not all of us who are in the categories that qualify for the flu jab have responded? I suppose that I qualify, having had a tumour removed and a heart bypass. I am having a tumour removed and I am having a heart bypass. I have a lot to thank the national health service for, and I rise to support it again. I have heard the figures. Will my right hon. Friend confirm that in the last year of the Tory Government there were 6 million flu jabs, yet this year there have been a record 14 million flu jabs? When I have mine next week, if I go—I found out this morning that it will be available—it will be 14 million and one, at least. Can there be a more sickening sight than Tory MPs who voted against—

Malcolm Rifkind: I can understand the hon. Gentleman's nervousness.
	On Monday 10 October, "Channel 4 News" reported:
	"We understand the Prime Minister wrote to Mr. Blunkett over the weekend asking for cuts to the planned levels of Incapacity Benefit . . . The Prime Minister's proposals would mean"—
	apparently, Channel 4 had seen a copy of the letter—that
	"average Incapacity Benefit claimants would be ten pounds a week worse off than under"
	the Secretary of State's own
	"plans. Many could be thirty to forty pounds a week worse off."
	It was said that the Prime Minister was
	"suggesting the benefits should be time limited"
	and
	"people could not claim it after two years and would move on to other benefits or no benefits."
	On Sunday 30 October, it was reported that, following a further memo from the Prime Minister—or it may have been the same memo—the previous Secretary of State had written to the Prime Minister saying that he could not accept the last-minute, hard-line changes to incapacity benefit that were being demanded by Downing street. Apparently, the demands in the Prime Minister's own memo to the Secretary of State included replacing part of the £76 per week given to incapacity benefit claimants with tokens that could only be spent on job training courses, and that incapacity benefit would be paid at jobseeker's allowance rates, which are, of course, far less than long-term incapacity benefit.
	We will expect the new Secretary of State to indicate what truth there is in those reports. Indeed, I am happy to give way to him now. Is he willing a this very moment to come to the Dispatch Box to say that neither he nor his predecessor has received representations from the Prime Minister or from No. 10 Downing street asking for the Green Paper to be changed to become more harsh with regard to incapacity benefit? Would he care to deny that those reports are true?

David Heathcoat-Amory: I hope that the hon. Lady will forgive me; I must reply to some of the points made.
	The hon. Member for Yeovil (Mr. Laws) referred to pensions. We did not hear a word on pensions from the Secretary of State, although pensions form part of both the motion and the Government's amendment. Of course the truth about pensions is that the halving of the savings ratio under the Government has dealt a body blow to the entire concept of private sector provision. The reason for that goes back, again, eight years to 1997, when in almost the Government's first fiscal action, they removed dividend tax credits from private pension funds. The Government's siphoning of money from the private sector pensions into the Treasury has gone on year after year. If the Prime Minister wants to pick a fight with a Department, I suggest that he should do so not with the Department for Work and Pensions, but with the Treasury and the Chancellor, because that is where the damage to pensions has been done.
	In 1997, our pensions system was an acknowledged international success. We had more private sector pensions under management than the rest of Europe put together. That fact has been alluded many times by the right hon. Member for Birkenhead (Mr. Field) and other hon. Members of all parties. That policy is now in ruins. Instead, the Chancellor's contribution to welfare reform—and his main legacy from the Treasury—will be a vast extension of means testing. Again, that has been alluded to in the debate. Almost half of all pensioners are now subject to means testing and the proportion is increasing. So the Treasury is responsible for not only the policy, but the shambolic administration of child and pension credits, as we know from our surgeries and advice centres, and the developing, unresolved mess that that is producing.
	In the debate, we have seen again the wide and growing gap between Labour's words and deeds. Despite repeated promises of reform, the welfare system is complex, badly targeted and sets up perverse incentives. It is prone to error, fraud and abuse. It lets down the taxpayer and those whom it is supposed to help. We should be having an open debate on how to change the system, instead of which it is a subject of repeated wrangles and leaked memos between No. 10 and the Department. It is time that the House expressed its displeasure and dismay about this continuing state of affairs, and I urge all my hon. Friends to vote for the motion.

John Gummer: I understand the Minister's problems and he knows that I generally support what he is trying to do. However, let me bring him back to the 20 per cent. figure. The right hon. Member for Oldham, West and Royton (Mr. Meacher) gave me some hell in the Chamber because the Labour party made that commitment in opposition. When it came to power, it reiterated it. If the Minister is now telling me that achieving the 20 per cent. is not possible—I warned him that it would be difficult—will he understand that we shall keep him to it? It may be a voluntary target, but if this country does not manage to meet it, the rest of world will believe that we have let it down on the most important issue that confronts us. The Government will not stand up and say, "We're going to do it. This is how we're going to do it. These are the tests that we'll use. We'll have independent checks every year." That undermines our belief in the Government's integrity and intelligence on the matter.

Norman Baker: The honest answer is that there is a lot more work to do on the proposal. We are moving towards taking radical measures to tackle climate change. A number of economists have suggested the carbon allowances approach: implementing the allowances could be achieved in a variety of ways, but none of them is particularly easy. My suggestion is that we could start with the transport sector, which is self-contained and could be ring-fenced. However, if the hon. Gentleman is asking whether we have solutions that we can distribute around the House, the answer is no, we have not.
	Another reason why too little is being done about climate change is that it is not high enough up the political agenda. By our actions, we are trying to correct that. We could do with some help from the media—a point that I regularly make—which insist on treating climate change, if they deal with it at all, as a purely scientific matter. They give the impression that no politicians of any party, including those in the Government, have anything to say about it. I, for one, am fed up with reports on the "Today" programme or stories in the broadsheets that go into great detail about horrendous and apocalyptic things going on in the world but which contain no comment from any politician. That means that no Minister is put on the spot and asked what is being done about the subject of the story, and the opinions of Members of Parliament are not sought either. Such stories and reports exist in a vacuum, outside the political process, so it is not surprising that politicians do not make progress on environmental matters. I hope that the media will reform their approach to these things.
	What should we do about policies that, collectively, are failing to deliver domestically the reaction to climate change that we need? The motion has been tabled by both Conservative and Liberal Democrats Members, and follows on from earlier debates and initiatives undertaken by myself and the right hon. Member for West Dorset. It wants to deal with the problem of climate change by putting it higher on the agenda, and telling the media that the story is political as well as simply scientific. It is designed to make it easier for the Minister and the good guys in government to argue with people who are perhaps less enlightened in other Departments, such as the Office of the Deputy Prime Minister. I hope that it will also help the Government to take difficult decisions in the knowledge that they will not be exploited for narrow party reasons.
	That is how the motion attempts to help the Government. I want action on climate change, and I want the problem to be tackled. That is one of the reasons why I am in politics. I am trying to make it easier for the Government to take the right decisions. That is what we are collectively trying to do.

Nick Hurd: I thank my hon. Friend for that intervention; I could not agree more. I hope that the Minister responds on behalf of Sonning common.
	There is much more room for the Government to send clearer market signals to consumers, businesses and investors about policy direction in terms of what kind of energy mix we want and the desire to grow markets for cleaner cars and cleaner fuels. They should set a much better example in terms of the standards that we expect from manufacturers of cars, electrical appliances and new homes. The Environmental Audit Committee produced a report that showed the Government's deficiencies in setting standards for public procurement. They are spending £500 billion of our money—a serious amount.
	The Government should be doing more to develop market instruments that will get them out of the business of picking winners. In the European Union emissions trading scheme, which was very diluted and weakened in its first phase, lies the key opportunity to set a real price for carbon that will change the framework of this debate.
	All this is in our national interest and in the global interest. It is do-able with political will, and it would be helped by political consensus. I am therefore very disappointed by the Minister's reaction to our motion. The major breakthrough required is the inclusion of the United States of America and the giants, and the emergence of an American President who sees it as being in the interest of the United States to lead this debate, not follow it.